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This is the first report of adalimumab-associated pulmonary cryptococcosis. A 56-year-old female with rheumatoid arthritis without a history of pulmonary disease was simultaneously administered adalimumab (40 mg/2 wks), methotrexate (4 mg/wk), and isoniazid (200 mg/ day). Five months later, chest radiography revealed a small spiculated pulmonary nodule, and the laboratory test results, including levels of tumor markers and plasma β-D-glucan, were within normal ranges. Since the lesion continued to grow, even after discontinuing adalimumab, it was surgically resected. Grocott staining of the tissue sample revealed blackbrown fungi, identified as Cryptococcus neoformans in culture. The patient now remains well, without adalimumab therapy.

We retrospectively reviewed the clinical and radiographic results of 30 revision total elbow arthroplasties in patients with rheumatoid arthritis using original surface prostheses developed in our institution. We asked whether a surface prosthesis is a suitable option for reconstructing a failed surface total elbow arthroplasty in terms of reproducing clinical performance compared with other devices such as semiconstrained prostheses. All 30 failed total elbow arthroplasties were performed with various surface prostheses and revised with Dogo Onsen Hospital surface prostheses. The mean age of the patients at the time of surgery was 64.9 years (range, 44-83 years), and the minimum followup was 3 years (mean 6.7 years; range, 3-11 years). The Mayo elbow performance index improved from 42.3 preoperatively to 76.3 at last followup. Pain, stability, and function scores improved after revision surgery, but range of motion scores were unchanged. Our data indicate a surface prosthesis is a reasonable option for reconstructing failed surface total elbow arthroplasties in patients with rheumatoid arthritis.